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DHBs are positive about influenza exercise

Media Release

30 January 2002

DHBs are positive about nationwide influenza pandemic exercise

District Health Boards and Public Health Services are responding enthusiastically to a month-long nationwide influenza pandemic response exercise, Ministry of Health Exercise Director Robyn Fitzgerald said today.

"We are really pleased with the commitment shown by District Health Board and Public Health Service staff to this challenging 30-day exercise. They have acknowledged the seriousness of a pandemic and identified the value of being prepared."

The Ministry of Health is evaluating the emergency response capabilities of the health sector by staging an influenza pandemic. Emergency response teams from the country's 21 District Health Boards, Public Health Services, the Ministry of Health and the National Pandemic Planning Committee are all taking part.

The exercise was important, as an influenza pandemic is one of the biggest threats to public health, said Mrs Fitzgerald.

"Influenza pandemics cause high rates of death and illness, can strike with only minimum warning and require a well coordinated national and regional response."

"By trialling our response methods the public can be reassured New Zealand's health sector will have a robust pandemic plan and be prepared to minimise disruption and death."

Since January 14, an evolving influenza pandemic scenario has been drip fed to District Health Boards and Public Health Services mimicking how an influenza pandemic might evolve in New Zealand.

As well as receiving the story and associated information, participants also receive questions asking how their region would respond to the scenario. Answers are submitted to the Ministry within a certain time frame and these, as well as participants' actions on site are monitored under the watchful eye of exercise observers and coaches.

Mrs Fitzgerald said participants had taken the exercise very seriously and she was pleased with the way questions about staffing levels, bed numbers and communication strategies for example were being answered.

"There have been many sound and innovative ideas submitted by exercise participants as they respond to the simulated story. While some of the ideas would need to be tested to check their validity, others have true merit and could be applied in a real pandemic situation. As would be expected there are local elements factored into answers as participants strive to meet the unique needs of their different regions."

The emergency response exercise is also testing the Ministry of Health's ability to establish communication networks so information can be shared. The exercise also tests the Ministry's ability to analyse and collate information for audiences including Government Ministers, health organisations and international agencies.

To properly trial participants' responses during the exercise the detailed scenario cannot be revealed to the media and public before the exercise finishes on February 14.

Mrs Fitzgerald said the influenza pandemic exercise was nine months in the planning. She said it is the first time a National Influenza Pandemic Plan has been tested on a national scale. International interest has been expressed from World Health Organisation members from Australia, Europe and the United States of America.

The Ministry of Health will release more information on the exercise as it progresses and a summary after February 14. Until then no further information is available.


For more information contact: Hayley Brock Media Advisor (04) 496 2115, 025 495 989

What is influenza? Influenza is a highly infectious illness caused by a virus.

What are the symptoms? Influenza usually causes two or three of the following symptoms: · Sudden onset of fever · Aches and pains · Severe fatigue · Headache · Cough · Sore throat · Stuffy or runny nose

How is it spread? Influenza is very infectious. It spreads through the air by coughing, sneezing and on hands, cups, cutlery or on other objects that have been in contact with an infected person's mouth or nose.

Adults are infectious for five days after symptoms occur and children for seven days.

How long does it last? Symptoms usually start to clear up after five to seven days.

Do antibiotics help? Antibiotics do NOT work against viruses, so they have no effect on influenza itself. Some people may need antibiotics because they have a secondary infection as well as influenza.

How common is influenza in the community? Each year different strains of influenza circulate in New Zealand. Most cases occur during the winter months.

What is an influenza epidemic? An epidemic occurs when there are a larger number of cases of influenza than normally expected.

What is a pandemic? An influenza pandemic occurs when a new type of influenza virus develops and this spreads to most countries of the world. Because the virus is new, no one has any immunity and many people become seriously ill.

An influenza pandemic has the potential to cause widespread death and illness as well as social and economic disruption.

Have we had a pandemic before or is it something new? The twentieth century has seen three true pandemics. The first and most devastating occurred in 1918-19, followed by the pandemics of 1957-58 and 1968-69.

What happened in 1918? The largest pandemic in history was in 1918. An estimated 20-40 million people died of the disease, which was notorious for its rapid onset and progression to respiratory failure and death. The highest numbers of deaths occurred in the 20-40 age group. Studies in New Zealand military camps showed that 30-40 percent were affected in the first wave and 50 percent by the second wave.

What happened in 1957 and 1968? In May 1957 the Asian influenza was identified in Singapore. By May 1958 it had spread worldwide. Infection rates were reported to range from 20-70 percent but fatalities were low ranging from 1 in 2000 to 1-10,000 infections. In New Zealand the pandemic began in Wellington in August 1957. The most at risk were people aged from 10-30 years. A second wave hit in late 1959.

In July 1968 a new type emerged in Hong Kong - it reached New Zealand in early 1969. Sporadic cases were reported during summer and autumn and it reached epidemic levels in June and July.

What is the likelihood of another pandemic occurring? The world will experience another influenza pandemic in the foreseeable future. It could occur at any time.

Influenza is an on-going and worldwide threat to public health. The ability of the influenza virus to change by mutation results in altered viruses, which can cause regular epidemics. In New Zealand epidemic influenza most commonly peaks in the winter months of July and August.

Are we at risk in New Zealand? Everyone worldwide is at risk. New Zealand would almost certainly be affected by an influenza pandemic.

What is the Ministry doing in preparation for the event? There has always been an awareness of the likelihood of a future pandemic. The Ministry of Health continues to update its Influenza Pandemic Preparedness Plan. The New Zealand Plan has been developed in consultation with the Australian Influenza Pandemic Planning Committee to ensure the plans are complementary. Dr Douglas Lush, Senior Advisor, Public Health Directorate, Ministry of Health, and Dr Lance Jennings are the New Zealand representatives.

What is the purpose of the plan? The purpose of the plan is to minimise the impact of an influenza pandemic on New Zealand.

The plan includes methods for the detection and management of pandemic influenza in New Zealand. It details surveillance techniques and guidelines for the use of vaccine and anti-virals.

Who is taking part in the emergency exercise? Ministry of Health staff District Health Boards Medical Officers of Health/Public Health Services National Pandemic Planning Committee.

Who has the Ministry of Health invited to watch? Thoracic Society, NZ Ambulance Service, NZ Blood Service, DPMC, Minister of Health, Civil Defence and Emergency Management, New Zealand Police, Ministry of Defence, Coroners Office, Wellington, BioSecurity, College of General Practitioners, New Zealand Nursing Council, Medical Council, Australian/New Zealand Society of Microbiologists, ESR, Ministry of Health Chief Advisers and Executive Team, Australian influenza pandemic experts, Glaxo-Smith & Kline, Roche.

Who will evaluate how well the exercise was carried out? Dr Bob Boyd, Chief Advisor Safety and Regulation, Ministry of Health. Dr Boyd will review the planning, conduct and control of the exercise and the response to the emergency and whether the exercise met the objectives. He will provide a report to the Minister of Health in March.

Who is on the National Pandemic Planning Committee (NPPC)? The committee is made up of a range of experts including virologists, microbiologists and public health specialists. The committee is able to co-opt experts from other disciplines when necessary.

What is the role of the NPPC? During inter-pandemic periods, the committee keeps up with advances in scientific knowledge and reviews planning, diagnosis and the treatment and management of influenza.

When the World Health Organization (WHO) confirms the presence of a new virus and its potential for human transmission, the NPPC becomes responsible for advising the Ministry of Health.

What factors decide when a pandemic occurs? A pandemic is declared when a new virus has been shown to cause several outbreaks in at least one country and has spread to other countries with consistent disease patterns.

What action will be taken to control spread of the virus when the pandemic occurs? As it is unlikely the outbreak would start in New Zealand, we would have some time to prepare for its arrival. There would be careful monitoring of the outbreak via increased communication with overseas agencies.

Once human to human transfer of a new virus was confirmed overseas, local surveillance programmes would be set up to detect the new strain in New Zealand.

The NPPC will regularly review the situation and decide what action would be appropriate. Some of the options would include limiting the movement of people or stopping international flights to delay the arrival of the virus in New Zealand, thus allowing more time for the country to prepare.

Does New Zealand have any surveillance systems in place at the moment? Yes - during the winter months a surveillance system is in place, which monitors the number of influenza cases and location. This surveillance programme runs from May to 1 October each year. The programme has been in place for at least 10 years.

Who is most at risk? Influenza has the potential to affect the majority of the population. As shown in previous pandemics, the target group varies.

What about vaccines? Vaccines for new types of influenza take time to produce and there is unlikely to be any vaccine available for New Zealanders for some months.

People 65 years and over and those with chronic disease should continue to have the routine influenza vaccine that is offered free of charge each year. This will provide protection from non-pandemic strains of influenza likely to be circulating during the influenza season.

In the event of a pandemic, would there be enough vaccine manufactured for the New Zealand population? It is likely that demand for vaccine will far exceed supply during a pandemic. Limited quantities of vaccine specifically for the new pandemic would possibly be available prior to the first wave of infection in some areas.

Who would be entitled to the vaccines? This is an issue that the NPPC would address and the decision would depend on what area was most severely affected and the age group most at risk.

Can we stockpile influenza vaccine? No. Because the virus is constantly changing, a vaccine is "made to order" specifically to target the new virus in a particular country.

Are there any other products, which may be of help? Anti-viral drugs are another method of protection and may shorten the course of the infection, if given early in the disease treatment. Anti-viral drugs can protect against influenza in the short term. These can be stockpiled, however, supply is unlikely to meet demand.

How will information be dispersed to meet the public demand? A web location will be set up containing practical advice about what people can do. It will cover issues such as the importance of fluid intake and at what stage a GP should be consulted.

The Ministry of Health may also consider setting up an 0800 number offering advice for the public.

Why does the influenza virus change? Evolution. The virus changes the protein on its shell (or coat) to avoid detection by the immune system of the host ie, us.

What is the difference between the influenza A and influenza B? There are two types of influenza - an "A" type and "B" type. The type B virus has different proteins and they do not change as rapidly or as dramatically. Type A also tends to cause more severe illness.

What about vaccines? Influenza vaccine has been marketed in New Zealand since the 1960s. Each year the vaccine is composed of three differing strains and the decision on which strains to include is made by a team, including the WHO, using surveillance information and predicting the most likely strains to be circulating. The vaccine is made up of the coat of the virus, which is inactivated and allows the recipient to develop protective antibodies against this strain.

How many people are vaccinated in New Zealand? At present approximately 12 percent of the New Zealand population is vaccinated annually, mostly those in the high-risk groups which includes those 65 years and over and people with chronic illness.

Hayley Brock Media Advisor Communications Corporate & Information Directorate Ministry of Health DD

Hayley Brock Media Advisor Communications Corporate & Information Directorate Ministry of Health DDI: 04 496 2115 Fax: 04 496 2010

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